The time period between the conception and delivery of a baby is known as pregnancy. During this period, the fertilized ovum which is a ball of cells during conception, undergoes a series of developmental changes and becomes a fully developed human in the mother’s womb. Pregnancy usually lasts for 40 weeks which is divided into 3 trimesters (First trimester-1 to 3 months, second trimester- 4 to 6 months, third trimester- 7-9 months). Each trimester is characterized by a noticeable set of bodily changes in the mother as well.
First Trimester (1 to 3 months): This is the most critical period for your baby’s development. By the end of the first trimester, your baby is almost fully formed. It has arms, hands, fingers, knees, feet, toes and mouth. During this period, you might experience symptoms such as morning sickness (nausea and vomiting), sore breasts, fatigue, food cravings and aversions, constipation, frequent urination, and weight gain.
Second trimester-(4 to 6 months): Your baby would grow at a rapid rate in this trimester. By the end of 4th month, your baby would be able to hear your sound and she would also be able to open her eyes. In this period, fine hair and a white waxy substance develop on the skin and serves as a protective sheath to the baby. Fingerprints and footprints are also well established. In this trimester you would start feeling the baby kicks around the 5th month. Other symptoms that you might notice during this period are- backache, changes in skin and hair, hemorrhoids, bleeding gums, congestion and nosebleeds, frequent urination, and varicose veins.
Third trimester (7-9 months): By the 7th month, your baby’s hearing is well developed, its lungs starts developing and it responds to stimuli such as light, pain and sound. Most of the organ systems start functioning normally by the 8th month. By the 9th month, the baby’s reflexes are well coordinated and the lungs are fully developed. The baby also descends down in order to prepare for delivery. The symptoms that you may notice in this trimester include- False labor pains, pain in the lower abdomen, backache, ankle swelling, breathing difficulty, breast enlargement, frequent urination and varicose veins. False labor pains are irregular, weak, do not increase in intensity with time, may stop or slow down with changes in movement and position of the body and is felt in the front of the lower abdomen. On the other hand, true labor pain come at regular intervals, strength of contraction goes on increasing with time, is not affected by change in position or movement, felt at the back first and then moves towards the front of the abdomen.
Tests during pregnancy
During pregnancy, you should visit a doctor for regular health check-ups to monitor your health and the health of the developing fetus. The following tests are routinely done during pregnancy:
- HCG levels: The levels of human chorionic gonadotrophin (HCG) in the blood are analyzed to confirm pregnancy. The blood HCG level above 25 mIU/ml confirms pregnancy.
- Blood grouping and Rh factor: Your blood group and Rh factor is determined during pregnancy to check for maternofetal Rh incompatibility. Rh incompatibility occurs when a Rh+ve mother has a Rh-ve fetus. This condition causes destruction of red blood cells in the fetus.
- Complete blood picture (CBC): Your doctor would recommend for a complete blood picture (CBC) test to observe the levels of blood components (RBCs, WBCs & platelets). Low levels of white blood cells indicate infection. Hemoglobin levels and red blood cell levels are regularly checked throughout pregnancy to detect anemia.
- Maternal Marker screening: These are a series of tests done in the second trimester to evaluate a woman’s risk of carrying a baby with chromosomal anomalies. It includes- double marker test, triple marker tests and quadruple marker test. These tests are helpful in detecting genetic defects such as Down’s syndrome and neural tube defect such as spina bifida in the fetus.
- Thyroid stimulating hormone (TSH) test: Pregnancy stresses the thyroid gland. During pregnancy there is may be a disproportionate increase or decrease in TSH levels due to abnormal thyroid functioning.
- Glucose tolerance test: Glucose tolerance test is performed to confirm gestational diabetes. This is done between 6th month of pregnancy. Gestational diabetes leads to macrosomia or increased size of the fetus.
- Tests for sexually transmitted diseases: Blood sample analysis can detect sexually transmitted diseases such as HIV, Hepatitis B, Syphilis. Such infections may increase your risk of miscarriage and preterm births.
During pregnancy, the levels of proteins, sugars, ketone bodies and bacteria are assessed in your urine sample.
- Urine glucose levels: High levels of glucose in urine indicate gestational diabetes. Pregnancy hormone (hCG) can decrease the insulin production, which may lead to gestational diabetes. Gestational diabetes may have detrimental effects on the health of the fetus.
- Assessment of protein: Presence of protein in the urine sample, when accompanied with high blood pressure, indicates of preeclampsia. If this is left untreated, it can cause growth retardation in the developing fetus.
- Urine culture: The presence of bacteria in your urine sample indicates urinary tract infection. The doctor would recommend a urine culture to determine the causative organism and prescribe appropriate antibiotic treatment
An ultrasound scan uses sound waves to create images of the growing fetus. Ultrasound monitoring helps your doctor to identify the baby’s position and movements. Before taking an ultrasound image, your doctor would ask you to drink plenty of water to obtain a clear image of the fetus. The ultrasound scan during the pregnancy is prescribed to assess the following:
- To verify the due date
- To detect ectopic pregnancy
- To check for multiple gestation
- To detect your baby’s heartbeat
- To assess the risk of genetic disorders
- To examine the growth and organ development of the fetus
- To assess the levels of amniotic fluid
- To identify pregnancy complications such as placenta previa
Dos and don’ts for a healthy pregnancy
Healthy diet: Food rich in protein, vitamins, minerals and fiber is a must for healthy development of the baby and relieving pregnancy symptoms. Focus on eating small frequent meals which keeps you energetic the entire day rather than a heavy meal.
- Fluid intake: Drink adequate amounts of water and fluids to stay hydrated. This helps in maintaining amniotic fluid levels and also prevents constipation.
- Improve sleep pattern: Sufficient sleep can help you to adjust to the physical and hormonal changes related to pregnancy.
- Exercise regularly: Walking, yoga and doing mild to moderate intensity exercises regularly help you to maintain your general health and reduce stress.
- Quit smoking: Nicotine which is a by-product of cigarette smoke has deleterious health effects in the fetus.
- Avoid caffeine: Drinking excess coffee and caffeinated drinks can cause heartburn and anxiety to the mother.
- Avoid alcohol: Consuming alcohol during pregnancy can cause birth defects and abnormal fetal growth.
- Avoid lifting heavy weights: Lifting heavy weights during pregnancy can cause joint injuries in the mother.
- Avoid uncomfortable clothing: Tight and uncomfortable clothing may increase breathing difficulty and swelling in the extremities.
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- Pregnancy (Pregnancy: An overview). http://www.aboutkidshealth.ca/En/ResourceCentres/PregnancyBabies/Pregnancy/Pages/default.aspx. Accessed on 07-10-2017
- Changes in your body during pregnancy: first trimester. https://familydoctor.org/changes-in-your-body-during-pregnancy-first-trimester/. Accessed on 07-10-2017
- Changes in your body during pregnancy: third trimester. https://familydoctor.org/changes-in-your-body-during-pregnancy-third-trimester/ . Accessed on 07-10-2017
- Blood tests during pregnancy. http://www.pregnancybirthbaby.org.au/blood-tests-during-pregnancy. Accessed on 07-10-2017
- Urine tests during pregnancy. https://consumer.healthday.com/encyclopedia/pregnancy-33/pregnancy-news-543/urine-tests-during-pregnancy-643994.html . Accessed on 07-10-2017
- 10 tips for a healthy pregnancy. http://www.parents.com/pregnancy/my-body/nutrition/healthy-pregnancy-tips/. Accessed on 07-10-2017